title: Difficult-to-treat infections.
abstract: The most common problems in the management of serious bacterial infections were reviewed. As illustrations, the diagnostic and therapeutic strategies in two types of deep-seated infections--both associated with a poor penetration of antibiotics--were discussed: (1) In suppurative central venous thrombophlebitis, conservative therapy frequently fails; if so, one should promptly switch to a surgical approach; (2) in most patients with a parapharyngeal space infection, a non-surgical approach can be recommended including early diagnosis by computed tomography (CT), CT-guided needle aspiration, prompt administration of benzylpenicillin in high and frequent dosages or continuously, and follow-up by CT. This regimen may prevent radical surgery even in the presence of deep neck or mediastinal abscesses.
authors.affiliation: Department of Bacteriology, University Hospital Rotterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: de Marie
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D002985:Clinical Protocols / Q000592:standards*; D004322:Drainage; D006801:Humans; D007362:Intensive Care Units; D009336:Necrosis; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D013492:Suppuration; D014652:Vascular Diseases / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D014683:Vena Cava, Superior
chemical_list: D000900:Anti-Bacterial Agents